Surgeon General sent 2.3 million doctors a letter this week. Here’s what it said

In a historic first, the U.S. Surgeon General Dr. Vivek H. Murthy has sent a letter to 2.3 million health care professionals, asking them to lead the movement to turn the tide on the nation’s prescription opioid epidemic.

“We often struggle to balance reducing our patients’ pain with increasing their risk of addiction,” Murthy writes. “But, as clinicians, we have the unique power to help end this epidemic.”

Surgeon General Dr. Vivek H. Murthy

Surgeon General
Dr. Vivek H. Murthy

Murthy unveiled his letter-writing campaign in March at the the 2016 Summit on RX Drug Abuse and Heroin in Atlanta. There, speaking with President Obama and other administration officials about the opioid epidemic, Murthy said,  215 million new opioid prescriptions are written every year, “enough to put a bottle of pills in the hands of every adult American.”

Murthy and others at the Summit pointed out that it is physicians who have driven the opioid epidemic with massive numbers of prescriptions.

In the letter mailed this week, Dr. Murthy urges clinicians to visit a website his office launched this month, TurnTheTideRx.org, where they can pledge their commitment to combating opioid misuse by enhancing education for treating pain, screening patients for opioid use disorder, and leading a shift in the public perception of addiction so that it is treated as chronic illness rather than as a moral failing.

This effort builds upon the U.S. Department of Health and Human Services (HHS) Opioid Initiative focused on tackling the nation’s opioid epidemic, as well as the National Pain Strategy, the federal government’s first coordinated plan to reduce the burden of chronic pain in the U.S.

In the letter, Dr. Murthy points out that nearly 20 years ago the medical community was encouraged to be more aggressive about treating pain. For instance, physicians beginning in about 1996 were being taught that fewer than one percent of all patients treated with narcotics were likely to become addicted. State medical boards warned of sanctions against doctors who failed to aggressively treat pain.

“Far too often, doctors have been in situations with patients who they believed were addicted to opioids,”  Murthy said at the conference, adding that physicians did not have the education or tools needed to know whether their prescriptions were alleviating pain or feeding an addiction.

As the number of prescriptions for opioid pain relievers increased, so did the number of deaths from opioid overdose. In 2014 alone, there were nearly 240 million prescriptions dispensed for opioids. In the same year, more than 14,000 people died from overdose of those drugs.

The letter also contains a pocket card outlining the CDC’s opioid prescribing guidelines. This marks the first time that a U.S. Surgeon General has sent a letter directly to the nation’s health professionals seeking their support in addressing a public health crisis.

Murthy’s efforts echo those of former Surgeon General C. Everett Koop’s historic letter to 107 million households regarding the AIDS epidemic. Former Surgeon General C. Everett Koop used his position to influence public discussion of HIV/AIDS.

Murthy isn’t stopping with a letter.  He’s compiling the first report by a surgeon general addressing substance abuse, addiction and health. Such reports carry clout: Think the tobacco report in 1964 on tobacco and the 1987 report on HIV/AIDS, both of which moved the needle on public discussions of major health issues. The report is expected later this year.

And, like Koop, Murthy intends to use his position as a bully pulpit to educate.

“I want to help the country see that (addiction) is not a moral failing, but a chronic illness that we need to treat with compassion, urgency and skill.”

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